WHO: Ebola death toll reaches 932; 1,700 cases

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WHO: Ebola death toll reaches 932; 1,700 cases

Q: Why are airlines concerned?

A: Airlines quickly take passengers from one part of the globe to another. With some germs, one sick passenger on a plane could theoretically infect hundreds of people who are connecting to flights to dozens of other countries. Health and airline officials note, however, that Ebola only spreads through direct contact. Outbreaks of diseases that can spread through the air, such as the flu and severe acute respiratory syndrome, or SARS, are more problematic for airlines.

(Photo by ZOOM DOSSO/AFP/Getty Images)

Q: Should people travel to West Africa?

A: The Centers for Disease Control and Prevention on Thursday issued a warning for Americans to avoid nonessential travel to the West African nations of Guinea, Liberia, and Sierra Leone.

(Photo by Associated Press)

Q: Is Ebola deadly?

A: Very much so. If contracted, there is no vaccine and no specific treatment. The World Health Organization estimated Monday that there have been 887 deaths from the current Ebola outbreak. That translates to a fatality rate of about 60 percent.

(AP Photo/Jonathan Paye-Layleh)

Q: How is Ebola transmitted?

A: The virus only spreads through direct contact with the blood or fluids of an infected person, according to the CDC. It can also be spread through objects, such as needles, that have been contaminated with infected fluids. No airborne transmission has been documented.

(Photo by SEYLLOU/AFP/Getty Images)

Q: Do U.S. airlines fly to West Africa?

A: Delta Air Lines flies to Dakar, Senegal; Accra, Ghana and Lagos, Nigeria. The airline also flies to Monrovia, Liberia, but for unrelated business reasons previously announced it will cancel that service at the end of September. Delta is letting passengers with flights to the region in the next two weeks push back travel until the end of the month. United Airlines also flies to Lagos, but has not issued any travel waiver. American Airlines does not fly to Africa.

(Photo by Andrew Harrer/Bloomberg via Getty Images)

Q: What are U.S. airlines saying about it?

A: There have been no flight cancelations. All three airlines said they are in regular communication with government agencies and health officials and will follow their recommendations.

(AP Photo/David Tulis, File)

Q: What about airlines from other countries?

A: European carriers such as Air France-KLM, British Airways and Lufthansa all fly to Western Africa from their hubs in Paris, Amsterdam, London and Frankfurt.

British Airways announced Tuesday that it is suspending flights to and from Liberia and Sierra Leone until Aug. 31 "due to the deteriorating public health situation in both countries." Passengers with tickets can request a full refund or a flight at a later date.

Lufthansa notes that "there is no risk of getting infected by the Ebola virus via air circulation during flight." Crews on Brussels Airlines flights have access to special thermoscans to check passengers' temperature, if they feel it's necessary. The only other airline, so far, to cancel any flights is the Middle East airline Emirates. It has suspended its service to Conakry, Guinea, until further notice. It is still flying to Dakar.

(AP Photo / Virginia Mayo)

Q: Are passengers leaving Africa being screened?

A: Since the outbreak erupted, the CDC has sent about two dozen staffers in West Africa to help try to track cases, set up emergency response operations and provide other help to control the outbreak. Last week, CDC officials said the agency will send 50 more in the next month. CDC workers in Africa also are helping to screen passengers at airports, according to CDC director Dr. Tom Frieden.

(AP Photo/David Goldman)

Q: Is the U.S. government doing anything extra for arriving passengers?

A: Border patrol agents at Washington's Dulles International Airport and New York's John F. Kennedy International Airport, in particular, are looking out for travelers who might have been exposed to the virus. They're watching for signs of fever, achiness, sore throat, stomach pain, rash or red eyes. The CDC also has staff at 20 U.S. airports and border crossings evaluating travelers with signs of dangerous infectious diseases and isolating them when necessary.

(AP Photo/David Goldman)

Q: Has the airline industry dealt with any outbreaks in the past?

A: In 2003, there was a global outbreak of severe acute respiratory syndrome, or SARS. The disease was first reported in Asia but quickly spread to more than two dozen countries in North America, South America and Europe. Unlike Ebola, SARS can spread when an infected person coughs or sneezes. During the 2003 outbreak, 8,098 people worldwide became sick with SARS; 774 of those died. Airports started screening incoming passengers for fever. The disease was devastating for airlines because fearful passengers stayed home.

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By Bashir Adigun and Krista Larson

ABUJA, Nigeria (AP) - A Nigerian nurse who treated a man with Ebola is now dead and five others are sick with one of the world's most virulent diseases, authorities said Wednesday as the death toll rose to at least 932 people in four West African countries.

The growing number of cases in Lagos, a megacity of some 21 million people, comes as authorities acknowledge they did not treat Patrick Sawyer as an Ebola patient and isolate him for the first 24 hours after his arrival in Nigeria last month. Sawyer, a 40-year-old American of Liberian descent with a wife and three young daughters in Minnesota, was traveling on a business flight to Nigeria when he fell ill.

The death of the unidentified nurse marks the second Ebola death in Nigeria, and this worries health experts as it is the Africa's most populous country and Lagos, where the deaths occurred, one of its biggest cities.

Ben Webster, a Red Cross disaster response manager in London, said it is "critically important" that people displaying symptoms are identified quickly.

"It's impossible to say whether this specific situation could have been avoided, but there is certainly more likelihood of travelers coming from an Ebola-affected country in the region and authorities need to be aware, even if the infrastructure and situation is challenging."

In Saudi Arabia officials say a man who was being tested for the Ebola virus has died. The 40-year-old returned on Sunday from Sierra Leone, where at least 286 people have died from Ebola, and was then hospitalized in Jiddah after showing symptoms of the viral hemorrhagic fever.

Spain's Defense Ministry, meanwhile, said a medically-equipped Airbus 310 is ready to fly to Liberia to repatriate a Spanish missionary priest who has Ebola. The ministry said Wednesday that preparations for the flight are being finalized but it is not yet known what time the plane will take off.

The priest, Miguel Pajares, is one of three missionaries being kept in isolation at the San Jose de Monrovia Hospital in Liberia who have tested positive for the virus, Spain's San Juan de Dios hospital order, a Catholic humanitarian group that runs hospitals around the world, said Tuesday.

There have now been at least 1,711 cases of Ebola this year, which has no proven vaccine or treatment, according to new figures released Wednesday by the World Health Organization. More than 932 people have died in Sierra Leone, Guinea, Liberia and Nigeria as of Aug. 4, WHO said. In announcing the new deaths, WHO noted in particular that "community resistance remains high" in Liberia. Many fearful family members are refusing to bring sick relatives to isolation centers, preferring to treat them at home and pray for their survival as no proven cure or treatment exists for Ebola.

The difficulties in quarantining sick people are complicating efforts to stop Ebola's spread.

In Nigeria, the five people now infected from Sawyer would not have been contagious to their neighbors or family members until they started showing symptoms of their own, health experts say. The delay in enforcing infection control measures, though, is another setback in the battle to stamp out the worst Ebola outbreak in history.

The specter of the virus spreading through Nigeria is particularly alarming, said David Morse, an epidemiology professor at Columbia University's Mailman School of Public Health.

"It makes you nervous when so many people are potentially at risk," he said.

Lagos is a bewildering combination of wealth and abject poverty, awash in luxury SUVs and decrepit buses alike that carry passengers through hours of crowded traffic on the bridges linking the city's islands to the mainland.

Ebola can only be transmitted through direct contact with the bodily fluids of someone who is sick - blood, semen, saliva, urine, feces or sweat. Millions live in cramped conditions without access to flushable toilets, and signs posted across the megacity tell people not to urinate in public.

Authorities in Liberia said Sawyer's sister had recently died of Ebola, though Sawyer said he had not had close contact with her while she was ill.

In announcing his death, Health Minister Onyebuchi Chukwu maintained that Nigerian officials had been vigilant.

"It was right there (at the airport) that the problem was noticed because we have maintained our surveillance," he told reporters. "And immediately, he went into the custody of the port health services of the federal ministry of health so there was no time for him to mingle in Lagos. He has not been in touch with any other person again since we took him from the airport."

On Tuesday, the Lagos state health commissioner said, however, that they did not suspect Ebola immediately and it was only after about 24 hours in the hospital that they identified him as a possible Ebola case.

"They went back to the history and they were like 'Oh, this is Liberia,' and that's why he was put into isolation," Lagos state health commissioner Jide Idris told reporters. "So even in that window period it was possible that some of these people got infected."

Nigeria was among the countries present at a regional meeting of health officials in Ghana at the beginning of July where they agreed to step up surveillance of potential Ebola cases and quickly share information with the World Health Organization.

Sawyer, who had a fever and was vomiting on the plane, was coming from the infected country of Liberia but had a layover in Togo. As a result, officials may not have initially known his original point of departure and it was unclear whether he was traveling on a Liberian or American passport.

Experts say people infected with Ebola can spread the disease only through their bodily fluids and after they show symptoms. Since the incubation period can last up to three weeks, some of the Nigerians who treated Sawyer are only now showing signs of illness that can mimic many common tropical illnesses - fever, muscle aches and vomiting.

The national health minister on Wednesday said special tents would be used to speed up the establishment of isolation wards in all of Nigeria's states. Authorities are setting up an emergency center in Lagos to deal with Ebola that will be "fully functional" by Thursday, he said.

"We are embarking on recruiting additional health personnel to strengthen the team who are currently managing the situation in Lagos," said his statement.

___

Larson reported from Dakar, Senegal. Associated Press writers Maram Mazen in Lagos, Nigeria and Mike Stobbe in New York contributed to this report.

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